EAST BAY — Marcia Torrey was finally ready. It was time to tell her husband Dick, in the late stages of lung cancer, that it was OK for him to go. And she told him in a way that only he would understand.

“When Dick was sick but still able to get around, he and I would go every day to Walley Street beach,” said Marcia, referring to the public spot off Hope Street in Bristol where walkers, picnickers and sunbathers feast on the spectacular views of Bristol Harbor.

“We’d get coffee, sit on the bench and wait for the 3:30 (Prudence) ferryboat. Then when he got so weak he couldn’t. He’d sit in the car and I’d sometimes sit on the bench.”

While Dick was in the Philip Hulitar Inpatient Center in Providence in August 2008, Marcia summoned up the strength to have one final conversation with her husband of nearly 60 years.

“I took his hand in mind — asking God to give me the strength — and then I told him it was time for him to catch the ferryboat,” said Marcia. “I said I’d come on a later boat because God needed me here.”

Dick passed away just six hours later. He was 80.

“He was a wonderful man — very involved in everything. His whole life was his family,” said Marcia.

Although Dick suffered from a terrible disease, he was able to spend the bulk of his final months at his Bristol home with Marcia. Being at home rather than in a hospital was important to her husband, who was very independent.

Hospice care made that possible. “I don’t know what I would have done without hospice,” said Marcia, who’s 79.

November is National Hospice/Palliative Care Month, and national and local hospice and palliative care agencies are getting the word out to increase awareness of the services they offer.

Dick and Marcia first met in Bristol, when she was 14 and he was 17. “He was a handsome thing,” Marcia recalled. “We didn’t date until I was 19 — it took him a while to realize he had a good thing! We were married very young. He worked for an architectural firms for years. That was his life — designing buildings — and then he went out on his own.”

The couple settled in Bristol but later lived in Barrington for 40 years. While there, Marcia worked in the high school library for 20 years, while Dick served on the school committee for eight years. They returned to Bristol about seven years ago, moving into a small Charles Street home, the site of a former Portuguese market.

Dick’s illness first reared its ugly head several years ago. “He coughed one entire year,” said Marcia.

At first the family thought it was his asthma, but a pulmonary doctor diagnosed him with stage-three lung cancer. “That is quite advanced. It was not operable, but he did decide to go with chemo and radiation which he had at the same time,” said Marcia.

One of his daughters, Carol Scott of Bristol, said her father was brave during his treatments. “He just never complained. Once in a while we’d stop at Delekta (Pharmacy in Warren) and get a coffee shake on the way home. And the last day of his chemo we had balloons and he had a hat on,” she said.

By the time of his 80th birthday in September 2007, Dick had completed his treatments and was feeling good. By the time the holidays rolled around, however, he suffered a relapse from which he never recovered. “When it came back, it just seemed to come back quickly,” said Marcia.

Accepting the inevitable, the family knew they needed help to make Dick’s final journey as comfortable as possible for him and his family. A team from Home & Hospice Care of Rhode Island started providing services in June 2008.

“He was still getting around by himself and was still going out a little, but he did decline rather steadily,” recalled hospice nurse Donna Clarke of Bristol, upon first meeting Dick.

She noticed right away that Dick liked to do things himself, particularly when it came to his medication and his movement around the house. “He’d go to his bedroom but he was stubborn — he kept wanting to get up. And it wasn’t really safe,” said Ms. Clarke, adding that a hospital bed was later brought in. “There’s always a balance with that kind of thing. You want to respect someone’s independence and their ability to do as much as they can, but also keep them safe.”

Marcia knew all too well how stubborn her husband could be. “He fought tooth and nail. Before, he insisted that I get him into the shower which was really not easy to do,” said Marcia, a slight woman who was 78 at the time. “I was so afraid he’d fall. Finally I told him, ‘I just can’t do it any more.’ So he agreed and we did have a health aid come in to bathe him.”

Marcia said hospice workers lifted a tremendous burden off family members’ shoulders during this time. “It was a lifeline. When I saw Donna and the others coming — we had a social worker who came a couple of times and talked to me, which was very helpful — it was like a blessing. It took the responsibility off of me, the worry, and I could ask them anything.”

Hospice care not only makes things easier on the patient, but family caregivers too, said Ms. Clarke. She tells patients: “Your goal is to stay at home, so we may have to do some things that you may not like as much, but it will help your caregiver.”

Marcia said hospice supplied “everything,” adding that she never had to even make a trip to the pharmacy. “All you had to say was, ‘Gee, it would be nice if I had a commode for the tub,’ and it was there that afternoon.”

Hospice benefit

Pam Taylor, director of communications for Home & Hospice Care of Rhode Island, said the hospice benefit eligible for people 65 and over who are on Medicare or those under 65 with a private insurer paying, is far-reaching. It covers not only the hospice interdisciplinary team (the nursing, the doctor, spiritually care, bereavement, volunteers, etc.), but any medical equipment the patient needs (hospital bed, commode, cane walker, etc.) as well as any medications related to the disease.

There are other facts about hospice of which many people are not aware, she said. “The greatest myth is the fact that people think it’s only for cancer. We treat people with any kind of life-threatening illness, whether it’s in-stage dementia, Alzheimer’s heart or lung disease, ALS,” said Ms. Taylor.

Another myth is that you have to give up your doctor. “We work with their physician. It’s really a collaboration,” she said.

There’s no reason to be afraid of hospice, according to Carolyn Bertsch, a hospice nurse with The Visiting Nurse Service (VNS) of Newport & Bristol Counties. The non-profit home health care and hospice agency, founded in 1950, serves around 25 to 29 hospice patients at any one time.

“I think a lot of people think that when you’re on hospice that we’re there to pretty much to end everything,” said Ms. Bertsch. “The philosophy of hospice is allowing patients to live their lives as comfortably as possible, so they can do as much as they can. We want to encourage the patients and their families to live their lives to the fullest.”

The key to overcoming myths about hospice is education, said Pauline Davis, hospice manager for VNS. “I think people get frightened of the word hospice and aren’t aware of the benefits it provides to them,” said Ms. Davis, adding that anyone with questions about hospice should call the VNS (682-2100) to set up an individual or group informational meeting.

Support after death

A hospice agency’s work is not done after a patient dies, either. Marcia was set up with a bereavement support person. “They keep in touch with people who’ve lost a loved one for at least a year after the passing and we have support groups all over the state,” said Ms. Taylor.

One program Home & Hospice Care operates is specifically for children ages 6-17. Camp BraveHeart, a two-day summer program run in partnership with Camp Fuller in Wakefield, combines traditional camp activities with grief support. It’s not just for kids with parents undergoing hospice care, but for any child that has lost a loved one.

“They have opportunities to memorialize their loved ones, to share. Like adults, they need the chance to talk about what they’re feeling. The best thing about the camp is that they know they’re not alone,” said Ms. Taylor, noting that the camp drew 109 kids last year.

VNS also provides services for families after a death, and also hosts memorial services and other events. (A memorial tree lighting will be held at the Portsmouth office on Tuesday, Nov. 24, at 4 p.m.)

Rewarding job

Ms. Clarke said hospice care can take an emotional toll not only on family members but hospice care workers like herself — she’s been known to share a cry with a patient — but she loves her job. She typically visits about five different hospice patients in their homes daily at any one time. (From September 2008 through Oct. 1 of this year, the agency provided hospice care to 342 patients in Bristol, Barrington, Warren, Little Compton, Portsmouth, Tiverton and East Providence.)

“You get so much back,” said Ms. Clarke. “It’s corny, but it’s the truth: You give and you receive love, and that’s the bottom line of life.”

Ms. Taylor hopes more families will take advantage of hospice care when it’s needed. “With more education, perhaps more people will be realizing that, ‘Maybe dad needs this kind of help, especially if mom’s trying to take care of him all by herself.’

“We like to say we provide hope, but a different kind of hope — hope for a better quality of life, hope for a lack of pain and symptoms.”

For more information about hospice and palliative care, contact a local hospice provide or the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org).

To read Marcia Torrey's moving essay about her final time with her husband Dick, pick up a Nov. 17-19, 2009 copy of East Bay Newspapers.